How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | None | $389.05 | $398.11 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | None | $398.11 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $436.52 | Facility | None | $125.89 | $204.17 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $707.95 | Professional | None | $354.81 | $398.11 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $776.25 | Professional | None | $446.68 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $851.14 | Professional | None | $295.12 | $371.54 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $691.83 | Professional | None | $363.08 | $363.08 | $691.83 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $194.98 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $77.62 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $295.12 |
Where Maryland sits
The same service costs 5.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 43rd of 51
$398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.